RESEARCH - DMARDs may reduce the risk of heart attacks and strokes: QUEST-RA

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ScienceDaily (Mar. 7, 2008) — Patients prescribed drugs to treat

rheumatoid arthritis could be at a reduced risk of heart attacks and

strokes, according to a new study.

An international team of researchers led by Naranjo of the

University of Las Palmas de Gran Canaria, Spain, and colleagues in

Argentina, Europe, and the USA have analyzed data from the QUEST-RA

(Quantitative Patient Questionnaires in Standard Monitoring of

Patients with Rheumatoid Arthritis) study. From this study,* including

4,363 patients from 48 sites in 15 countries, the team has examined

the causes and effects of rheumatoid arthritis, as well as the

potential benefits of medications.

Rheumatoid arthritis is a known risk factor for hardening of the

arteries and so can lead to stroke and heart attacks occurring in

sufferers ten years earlier than in people without the condition.

However, earlier studies have shown that treating rheumatoid arthritis

with disease-modifying anti-rheumatic drugs (DMARDs), such as

methotrexate, may reduce this risk. The current research quantifies

this risk reduction in thousands of patients in the QUEST-RA study.

Naranjo and colleagues found that risk, when adjusted for age, sex,

disease activity, and traditional risk factors such as lack of

exercise, smoking, diabetes, and high cholesterol levels, correlated

strongly with the use of drugs to treat rheumatoid arthritis. Taking

methotrexate -- the most widely used DMARD -- for just one year for

example was found to be associated with an 18% reduction in risk of

heart attack and an 11% decrease in risk of stroke, the researchers

say.

" Our study provides further support of the influence of both

traditional and RA specific risk factors in the development of

cardiovascular events, especially heart attack " the researchers

conclude, " As assessed by this study, the risk was lower with the

prolonged use of methotrexate, sulfasalazine, glucocorticoids,

leflunomide and TNF-± blockers. "

In an accompanying editorial, Dr van Vollenhoven of Karolinska

Institute, Sweden, reviews the research article. " The possibility that

antirheumatic therapy decreases the risk for cardiovascular

complications is tantalizing, " writes the author. " The current study,

while not exactly proving this point, adds a further measure of

support to the concept, and suggests that it must now be formally

addressed.

*Journal reference: Cardiovascular disease in patients with rheumatoid

arthritis. Results from the QUEST-RA study Naranjo, Tuulikki

Sokka, A Descalzo, Calvo-Alen, Kim Horslev-sen,

Reijo K Luukkainen, Bernard Combe, Gerd R Burmester, Joe Devlin,

Gianfranco Ferraccioli, Alessia Morelli, Hoekstra,

Majdan, Stefan Sadkiewicz, Belmonte, Ann-Carin Holmqvist,

Ernest Choy, Recep Tunc, Aleksander Dimic, Bergman,

Toloza and Theodore Pincus. Arthritis Research & Therapy (in press)

http://arthritis-research.com/content/10/2/R30

Adapted from materials provided by BioMed Central/Arthritis Research &

Therapy, via EurekAlert!, a service of AAAS.

http://www.sciencedaily.com/releases/2008/03/080306075231.htm

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Not an MD